Educational environment of university and non-university hospitals in Japan

Objectives: The greater satisfaction of residents in nonuniversity hospitals in Japan found in a previous survey may reflect a better educational environment in these hospitals compared to university hospitals. We aimed to compare the educational environment of university hospitals and nonuniversity hospitals. Methods: A cross-sectional survey was sent to 6725 1styear resident physicians. The Postgraduate Hospital Educational Environment Measure (PHEEM) was used as a reliable and validated instrument to evaluate the educational environment of teaching hospitals. Results: A total of 2429 PGY-1 physicians-in-training (38% women) completed the questionnaire (response rate, 36%). The mean total scores on the PHEEM ranged from 77 to 125 (mean, 99) for 80 university hospitals, and from 46 to 149 (mean, 102) for 255 non-university hospitals. The PHEEM score was significantly higher for non-university hospitals compared to university hospitals (p=0.001). Among the top ten of hospitals with the greatest scores, there were nine non-university hospitals but only one university hospital. Conclusions: The difference in educational environment may explain the greater satisfaction of non-university residents in Japan and account for the massive shift of residents from university to non-university hospitals after introduction of the new postgraduate medical education program in Japan.